How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $64.57 Typical High $66.07 | Professional | None | $45.71 | $64.57 | $66.07 |
BCBS Kansas Setting Facility Modifier None Typical Low $67.61 Median $70.79 Typical High $70.79 | Facility | None | $67.61 | $70.79 | $70.79 |
BCBS Kansas Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $69.18 | Professional | None | $58.88 | $58.88 | $69.18 |
Medica Setting Facility Modifier None Typical Low $45.71 Median $72.44 Typical High $407.38 | Facility | None | $45.71 | $72.44 | $407.38 |
Medica Setting Professional Modifier None Typical Low $37.15 Median $58.88 Typical High $446.68 | Professional | None | $37.15 | $58.88 | $446.68 |
United Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $107.15 | Facility | None | $91.20 | $91.20 | $107.15 |
United Setting Professional Modifier None Typical Low $28.84 Median $43.65 Typical High $60.26 | Professional | None | $28.84 | $43.65 | $60.26 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $32.36 Typical High $33.11 | Professional | 52 · Reduced service | $22.91 | $32.36 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $12.88 Typical High $13.18 | Professional | 53 · Discontinued | $9.12 | $12.88 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $9.77 Typical High $9.77 | Professional | 55 · Aftercare only | $6.76 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $6.46 Typical High $6.61 | Professional | 56 · Pre-op care only | $4.57 | $6.46 | $6.61 |
Where Kansas sits
The same service costs 2.0 times more in Montana than in South Carolina. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Kansas· 14th of 51
$70.79
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.